next »

[zarathustra]

There's lots of discussion about SSRI's here on the threads, but I couldn't find one exactly that deals with taking them for the first time.  Forgive me if I'm mistaken...

My GP prescribed Prozac for me today after I mentioned I'd been depressed a bit this summer.  I wanted me to at least try it, he said. I start with a 1/2 tablet for the first 4 days. No discussion of consulting a therapist, though I'm sure he'd refer one if I asked.  My only concern, from what I've read, is that it can be difficult to find the right kind and amount of SSRI's to take, and once on them--difficult to get off.  He disagreed.  *shrug*  I think it's worth trying.

I don't know if I should be concerned about the lack of corresponding therapy, but then again I don't have a particular crisis right now. I've just been exceptionally weepy and moody all summer.

Thoughts?

[concordancia]

While therapy has been shown to be quite effective in combination with SSRIs, my therapist decided I was cured and discontinued therapy right after I started taking them.

As for the doses and getting off, most people seem to do OK on any for a short time, especially if all you need is a few chemicals to put you back in balance, then your body can keep up on its own.

FYI, I got the shakes when I started taking them, but had no trouble stopping.

[detritivore]

I took Zoloft for a while without seeing a therapist.  It didn't do me much longterm good.  I eventually quit taking it.  Then later I started taking Lexapro which I thought was doing a pretty good job.  But, then I started seeing an awesome therapist in conjunction with taking the medication, and overall that has been an incredible experience.  I have grown and have learned a lot in that process and I think they complemented each other well.  I would really recommend that you see a therapist if you are depressed enough to be taking pills.  You don't need your doctor to prescribe you one.  Also, I don't know... but I wouldn't be comfortable seeing a doctor who didn't really discuss your concerns about your mental health and his prescription.  Something to think about. 

[multinodal]

Even if there isn't an obvious crisis, something is psychologically shifting for you, so I would certainly lean towards at least trying therapy - although the process of finding the right therapist is often annoying.

I have just started reading "Anatomy of an Epidemic" which reviews a lot of biomedical literature and essentially asserts that SSRIs are prescribed even though there is no scientific evidence that seratonin imbalance is the problem in depression. Most alarmingly, the author asserts that changes in the brain take place within the first few weeks of taking the drug(s) and these changes create irreversible chemical and other imbalances.

I've been taking an SSRI for many years, so if this is true, it's too late for me and my brain, but reading this book makes me want to immediately stop taking my anti-depressant and start vigorously exercising and do all the other non-drug reliant things that are supposed to combat depression.

[prytania3]

You want the truth?

SSRIs don't do much for me, but Prozac made me suicidal. But, I'm bipolar, so...

[fiona]

You want the truth?

SSRIs don't do much for me, but Prozac made me suicidal. But, I'm bipolar, so...

I have a close friend, not bipolar, who felt suicidal on Prozac, and apparently that's not uncommon. I don't know if the book _Listening to Prozac_ is useful, but you might want to look into it.

The Fiona, who's never taken SSRI's so I'm only reporting what I've been told

[oak_and_ash]

I've taken Paxil (a low dose of 10 mg), tapered off of it just fine, and went back on it a couple of years ago.  I don't see a therapist normally (I've gone a couple times with my SO to her therapist and I see one if there's a major crisis, but not on a regular basis).  This works for me, as the Paxil stabilises my mood enough that I don't slip into a major depressive episode even when very stressed - in a way that just good exercise and diet doesn't.  But please do tell your doc if you start feeling suicidal or have any other side effect you can't abide.  He might suggest another anti-depressant, since different ones work for different people. 

That said, do see a therapist if you think it would be useful for you.  And you may decide that meds are not for you, as my best friend has.  Also, if you have had a lot of unstructured time this summer, this could be contributing to your emotional state.  I usually feel better when I have to teach, since I have a structure.  Good luck! 

[msparticularity]

If one has a tendency toward either anxiety or manic episodes, Prozac is rather likely to tip one further in that direction. It also, however, is among the easiest of SSRIs to go off of due to its very long half-life; it tapers down on its own. I took Prozac a couple of times not too long after it first came out, and did okay until the anxiety escalated. Later, a GP put me on Zoloft instead and I had very severe side-effects that got hideous when I tried to go off. My (far more knowledgeable) psychiatrist then ended up putting me on Prozac to get me off of the Zoloft and eventually off of the Prozac.

[britmom]

I haven't been on Prozac, but I have taken two types of SSRI's. The first (Sertraline) worked initially, but then caused extreme mood swings. I'd be dancing around and laughing one minute, and then deeply suicidal the next. The second one I tried (Citalopram) has been wonderful, but I couldn't tolerate a high enough dose (it caused hypomanic symptoms), so I've ended up supplementing it with two additional medications. I honestly don't think I'd still be here without the medication.

However, if you are suffering mild-ish depression, I'd suggest you try therapy (and, if appropriate, some life-style changes) first. Perhaps Omega 3, too? Also, have you had your thyroid function checked? An underactive thyroid can cause depression.

[zarathustra]

I haven't been on Prozac, but I have taken two types of SSRI's. The first (Sertraline) worked initially, but then caused extreme mood swings. I'd be dancing around and laughing one minute, and then deeply suicidal the next. The second one I tried (Citalopram) has been wonderful, but I couldn't tolerate a high enough dose (it caused hypomanic symptoms), so I've ended up supplementing it with two additional medications. I honestly don't think I'd still be here without the medication.

However, if you are suffering mild-ish depression, I'd suggest you try therapy (and, if appropriate, some life-style changes) first. Perhaps Omega 3, too? Also, have you had your thyroid function checked? An underactive thyroid can cause depression.

I've made a lot of life-style changes in the past 2 years, like getting a dog, which meant 2 walks a day and sticking to a schedule.  I've given up my evening beer or wine, and all the pretty liqueur bottles are boxed up and in the closet...available if a recipe calls for them but otherwise will probably be given away.  I take fish oil pills.  I'm eating better and upping the exercise to jogging (well, wogging---walking + jogging).

Did a blood test this morning, which includes a TSH test.

Doing therapy would the hardest thing to start.  I don't have any teaching-free days in my schedule, and meetings go on top of that and gigs on some weekends.  Plus, it's going to be hard to find a good therapist around here, I'm guessing.  But if I have to do it, I will. 

I've just never felt like I *had* to do get therapy.  Maybe I've been trying to do everything I can think of on my own first. 

Anyway, day one on 1/2 Prozac feels er, crampy.  Or maybe it's the 18 miles I biked yesterday plus fasting for the blood test?  We'll see...

[britmom]

When it came down to it, I knew that I had to start taking the antidepressants (which was sertraline, at first.) I had exactly the same reservations as you do, but, if nothing else, they gave me some hope that I wouldn't always feel the way I did. Good luck with the Prozac. I had stomach cramps when I started the sertraline. They only lasted a couple of days.

I was very unsure about therapy. (I only started a few months ago due to the NHS waiting list.) I wasn't convinced it was helping at all for the first 4 or 5 sessions. However, I've found it very helpful since then. Last week I really grasped the fact that the way I think about the depression, and my relationship to 'it', was making things worse. I'm hopeful that it will help me to avoid sinking too low in the future by equipping me with a better understanding of the illness and coping mechanisms for when things start to go wrong. I think the medication help keep things stable at this point in time, whereas the therapy has the potential to provide me with life-long skills to keep myself mentally healthy.

[llanfair]

I've been taking Paxil for free-floating anxiety since 2005, and I must admit, I love it.  Not only does it help me to stop the whirling spinning-wheel of panicky thoughts, but it's helped with PMS and perimenopausal mood swings as well. 

I did go to therapy for about 18 months, some years previous to starting Paxil, and while it helped to realise what was going on - worrying + "bad inner dialogue" - it didn't really help me stop that spiral once it started.  The Paxil has done that for me, with no side-effects that I can discern other than delayed orgasm (sorry if TMI).

[neutralname]

Different people like different things, but academics tend to be very verbal people and respond well to therapy.  It makes a great deal of sense to do therapy if you learn skills that you can use for the rest of your life.  Obviously taking medication, even if it is helpful, does not have the same kind of life-long benefit as therapy that teaches skills. 

I'd recommend finding a therapist who keeps up with psychology and who has a good deal of experience.  It makes sense to have a therapist who uses techniques that have been proven to work.  It is definitely worth spending time before you commit to a particular therapist asking what their approach will be.  They are likely to be rather cagey and waffley, so you might need to press them on the issue.

[oldfullprof]

The Anatomy of an Epidemic stuff is pure bullsh!t.  New York Review published a two-part by one of those idiots, and the responses took her apart.  There's a similar anti-Viagra movement that I'll be addressing in a paper this fall.  Some of this comes from now-discredited labeling theory (when applied to biological conditions,) popular in the 70s.  

I take Effexor (isomer of Lexapro, I believe.)  No side effects.  (Well, it does make ejaculation difficult-- but some might like this.)  I've heard bad things about Prozac, though, and Zoloft.  

[neutralname]

The reply by the current president of the American Psychiatric Association was very insubstantial - a stock response.
http://www.nybooks.com/articles/archives/2011/aug/18/illusions-psychiatry-exchange/
The other letters were more thoughtful, but they hardly ended the debate and Angell gave a good rebuttal to them.

One of the biggest problems for people seeking psychiatric help these days is that the experts can't agree about which treatments work, and so much of the science is tainted by the influence of the drug companies that it is hard to know who to believe.